Provider Demographics
NPI:1497709653
Name:LEVITAN, ARKADY (MD)
Entity Type:Individual
Prefix:
First Name:ARKADY
Middle Name:
Last Name:LEVITAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297156
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-7156
Mailing Address - Country:US
Mailing Address - Phone:718-376-2625
Mailing Address - Fax:718-336-5291
Practice Address - Street 1:2925 W 5TH ST STE 52
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3962
Practice Address - Country:US
Practice Address - Phone:718-376-2625
Practice Address - Fax:718-336-5291
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2163082084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02195742Medicaid
NYH09137Medicare UPIN
NY05650AMedicare ID - Type UnspecifiedGHI
NY02195742Medicaid